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Background  Elevated  Staphylococcus aureus  and oral bacterial concentrations are known to correlate with pneumonia hospitalization in nursing home residents. However, the effects of a professional oral care intervention on these factors remain unclear. The aims of this quasi-experimental study were to compare bacterial concentrations in saliva and sputum, oral health status, distribution of  Staphylococcus aureus , and pneumonia status before and after a professional oral care intervention.    Methods  A purposive sample of residents from two nursing homes was divided into an intervention group that received a weekly professional oral care intervention and a control group. Oral bacterial concentration was determined by real-time polymerase chain reaction. The  Staphylococcus aureus  distribution was determined by bacterial culture and matrix-assisted laser desorption/ionization–time of flight mass spectrometry. After data collection, a statistical analysis was performed to evaluate the effect of the intervention.    Results  Most residents were unconscious (80%), and most had a history of pneumonia (76%). Baseline demographic data did not significantly differ between the two groups. After the intervention, the intervention group had significant improvements in plaque index (1.66 ± 0.78 vs. 0.94 ± 0.64,  p  <  0.01), gingival index (2.36 ± 0.76 vs. 1.65 ± 0.83,  p  <  0.01), tongue coating index (0.96 ± 1.10 vs. 0.16 ± 0.47,  p  <  0.01), distribution of  Staphylococcus aureus  in salivary samples (11.11 ± 14.47% vs. 1.74 ± 3.75%,  p  = 0.02), and salivary bacterial concentration ([4.27 ± 3.65] × 10 5  vs. [0.75 ± 1.20] × 10 5 ,  p  <  0.01). Sputum bacterial concentration did not significantly differ. The intervention group also had a significantly lower annual prevalence of pneumonia hospitalization (1.24 ± 1.51 vs. 0.48 ± 0.59,  p  = 0.01), especially in residents whose salivary bacterial concentration exceeded the median. However, the duration of pneumonia hospitalization did not significantly differ between the two groups.    Conclusion  A professional oral care intervention in nursing home residents can improve oral health, reduce levels of salivary bacteria and  Staphylococcus aureus , and decrease the annual prevalence of pneumonia hospitalization.    Trial registration  Trial registration:  ClinicalTrials.gov ,  NCT03874962 . Registered 12 March 2019 - Retrospectively registered.

bmc infectious diseases

The effect of oral care intervention on pneumonia hospitalization, Staphylococcus aureus distribution, and salivary bacterial concentration in Taiwan nursing home residents: a pilot study